Everything Pregnancy

Cholestasis: An Itch You Can't Scratch

Chronic itching during pregnancy could be due to intrahepatic cholestasis of pregnancy, a rare but serious condition that can result in stillbirth. 

Mom Warns Severe Itchiness During Pregnancy Might Be More Dangerous Than It Seems

Pregnancy symptoms run the gamut from headaches and sinus congestion to nausea, exhaustion, and irritability, and an exaggerated of sense of smell. And sometimes, extreme itchiness: Michigan mom-to-be Christina DePino was just a few months into her pregnancy when she too noticed the odd symptom.

"The itching was so severe that I would wake up and I wouldn't be able to go back to bed, and my legs and arms were scabbed and bleeding from the uncontrollable need to scratch," DePino told CBS News.

DePino, understandably, didn't know what to attribute the unbearable itchiness to. That's when a Facebook post bemoaning her misery led to the answer she was seeking. Commenters suggested she might have intrahepatic cholestasis of pregnancy (ICP).

ICP is a liver disorder that occurs during pregnancy, according to the American Liver Foundation. Normally, chemicals in the bile of the liver (bile acids) help with digestion, but with cholestasis, the bile flow slows down and acid builds up in the patient's blood. This results in itching that can vary from bothersome to severe and is often worse at night, says the ALF. 

"If a pregnant woman is specifically scratching at the palms of her hands and the soles of her feet, she may have cholestasis and this can be dangerous for the baby," says Michele M. Hakakha, M.D., a board-certified OB/GYN and co-author of Expecting 411: The Insider's Guide to Pregnancy and Childbirth. "Although most causes of itching are not harmful, it is important to bring this up to your practitioner."

See your doctor immediately if you develop any of the following "red flag" symptom combinations: 

  • Nausea, vomiting, and itching
  • Severe fatigue and itching
  • Yellowing of the skin (particularly palms, soles, eyes) and itching 
  • Any rash and itching

Other conditions that cause itchiness include pemphigoid gestationis (previously called herpes gestationis) and PUPPP (pruritic uticarial papules and plaques of pregnancy). Both conditions can put the baby, and sometimes the mom, at risk. 

A doctor diagnosed DePino with the condition at 36 weeks. Because cholestasis can have severe repercussions for a growing baby, including a very high risk of death after 37 weeks, DePino was induced a week later. She and her husband, Aaron, welcomed a healthy baby girl. 

DePino took to Facebook to share a warning to other expectant moms who might be suffering from uncomfortable itchiness.

"If your pregnant & your [sic] itching REALLY bad, don't ignore it!!" DePino wrote in her post. She goes on to say, "I got the itch checked out & found out I had pregnancy cholestasis, which is basically harmless for me—except for the crazy itching—but could have caused [my baby to be] still born after 37 weeks! I was officially diagnosed last week and had to get her out this week!"

Treatment for Itchiness

It's imporatant to note that itchy skin during pregnancy can be very normal. "Many women get itchy for no other reason than the skin over the belly is continually being stretched and this can lead to dryness, stretch marks, and itching," says Dr. Hakakha explains. "Most cases are harmless." 

To cut down on itching, Dr. Hakakha suggests the following: 

  • Use a moisturizer twice a day and immediately after a shower or bath.
  • Use anti-itch creams like calamine lotion, 1% hydrocortisone cream, or diphenhydramine (Benadryl) cream.
  • Avoid taking really hot showers which can dry out your skin.
  • Drink plenty of water to stay well-hydrated.
  • Try an oatmeal bath. 
  • Avoid spending long periods of time in hot weather or in the sun (which can make itching worse).

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Melissa Willets is a writer/blogger and soon-to-be mom of 4. Find her on Facebook where she chronicles her life momming under the influence. Of yoga.